tbuckley/cabot-search huggingface dataset:
Artificial intelligence assisted endoscopic ultrasound for detection of pancreatic space-occupying lesion: a systematic review and meta-analysis
Authors: Arkadeep Dhali, Vincent Kipkorir, Bahadar S. Srichawla, Harendra Kumar, Roger B. Rathna, Ibsen Ongidi, Talha Chaudhry, Gisore Morara, Khulud Nurani, Doreen Cheruto, Jyotirmoy Biswas, Leonard R. Chieng, Gopal Krishna Dhali
Journal: International Journal of Surgery (2023)

Diagnosing pancreatic lesions, including chronic pancreatitis, autoimmune pancreatitis, and pancreatic cancer, poses a challenge and, as a result, is time-consuming. To tackle this issue, artificial intelligence (AI) has been increasingly utilized over the years. AI can analyze large data sets with heightened accuracy, reduce interobserver variability, and can standardize the interpretation of radiologic and histopathologic lesions. Therefore, this study aims to review the use of AI in the detection and differentiation of pancreatic space-occupying lesions and to compare AI-assisted endoscopic ultrasound (EUS) with conventional EUS in terms of their detection capabilities.
A commentary on ‘Meta-research studies in surgery: a field that should be encouraged to assess and improve the quality of surgical evidence’
Authors: Si-Un Frank Chiu, Ru-Yi Huang, Chong-Chi Chiu
Journal: International Journal of Surgery (2023)

aDepartment of Computer Science, Brown University, Providence, Rhode Island, USA bDepartment of Economics, Brown University, Providence, Rhode Island, USA cDepartment of Family Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan dSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan eDepartment of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan fDepartment of Medical Education and Research, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding Author. Address: No.21, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung, 824, Taiwan. Tel: 886-76150022. Fax: 886-76150940. E-mail address: [email protected] (C-Chi. Chiu). This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/
Defining and predicting textbook outcomes for perihilar cholangiocarcinoma: analysis of factors improving achievement of desired postoperative outcomes
Authors: Lucrezia Clocchiatti, Rebecca Marino, Francesca Ratti, Federica Pedica, Andrea Casadei Gardini, Dario Lorenzin, Luca Aldrighetti
Journal: International Journal of Surgery (2023)

Background: Definition of Textbook Outcome (TO), defined as a single indicator combining the most advantageous short-term outcomes, is still lacking for Perihilar Cholangiocarcinoma (PHC). The primary endpoint of the present study is to analyse the rate of achievement of a disease-specific textbook outcome for peri-hilar cholangiocarcinoma within a high volume tertiary referral center. Secondary endpoints are to identify predictive factors of TO achievement and to analyze the impact of achieving textbook outcome on long-term results. Methods: Between 2010 and 2022, a total of 237 patients undergoing combined liver and biliary resection for PHC at tertiary referral center were included. Disease-specific TO were defined as: no 90-days mortality, no postoperative complications, no readmission, no intraoperative transfusions and R0 margins. A logistic regression model was developed to identify predictors associated with TO achievement. Kaplan-Meier curves were designed to determine TO’s impact on survival. Results: TO was achieved in 60 (25.3%) patients. At multivariate logistic regression, preoperative biliary drainage (OR 2.90 (1.13 – 3.40), P =0.026), high prognostic nutritional index (OR 7.11 (6.71 – 9.43), P =0.007) and minimally-invasive approach (OR 3.57 (2.31 – 3.62), P =0.013) were identified as independent predictors of TO. High ASA score (OR 0.38 (0.17 – 0.82), P =0.013) decreased the odds of TO. A significant improvement in both overall survival and disease-free survival was associated to TO fulfilment. Conclusion: Since the achievement of textbook outcome correlates with better disease-free and overall survival, every effort should be made to ameliorate modifiable aspects prior to surery: management within referral centers with dedicated experience in biliary tract cancer and preoperative optimization protocol may positively contribute to improve postoperative outcomes, increasing the chance to obtain TO. Moreover, the implementation of advanced minimally invasive programs plays as well.
Trends in new and persistent opioid use in older adults with and without cancer
Authors: Laura Van Metre Baum, Madhav KC, Pamela R Soulos, Molly M Jeffery, Kathryn J Ruddy, Catherine C Lerro, Hana Lee, David J Graham, Donna R Rivera, Michael S Leapman, Vikram Jairam, Michaela A Dinan, Cary P Gross, Henry S Park
Journal: JNCI Journal of the National Cancer Institute (2023)

Abstract Background The impact of ongoing efforts to decrease opioid use on patients with cancer remains undefined. Our objective was to determine trends in new and additional opioid use in patients with and without cancer. Methods This retrospective cohort study used data from Surveillance, Epidemiology, and End Results program–Medicare for opioid-naive patients with solid tumor malignancies diagnosed from 2012 through 2017 and a random sample of patients without cancer. We identified 238 470 eligible patients with cancer and further focused on 4 clinical strata: patients without cancer, patients with metastatic cancer, patients with nonmetastatic cancer treated with surgery alone (“surgery alone”), and patients with nonmetastatic cancer treated with surgery plus chemotherapy or radiation therapy (“surgery+”). We identified new, early additional, and long-term additional opioid use and calculated the change in predicted probability of these outcomes from 2012 to 2017. Results New opioid use was higher in patients with cancer (46.4%) than in those without (6.9%) (P &amp;lt; .001). From 2012 to 2017, the predicted probability of new opioid use was more stable in the cancer strata (relative declines: 0.1% surgery alone; 2.4% surgery+; 8.8% metastatic cancer), than in the noncancer stratum (20.0%) (P &amp;lt; .001 for each cancer to noncancer comparison). Early additional use declined among surgery patients (‒14.9% and ‒17.5% for surgery alone and surgery+, respectively) but was stable among patients with metastatic disease (‒2.8%, P = .50). Conclusions Opioid prescribing declined over time at a slower rate in patients with cancer than in patients without cancer. Our study suggests important but tempered effects of the changing opioid climate on patients with cancer.
Redirecting AAV vectors to extrahepatic tissues
Authors: Aravind Asokan, Shen Shen
Journal: Molecular Therapy (2023)

Recombinant adeno-associated viral (AAV) vectors are the current benchmark for systemic delivery of gene therapies to multiple organs in vivo. Despite clinical successes, safe and effective gene delivery to extrahepatic tissues has proven challenging due to dose limiting toxicity arising from high liver uptake of AAV vectors. Deeper understanding of AAV structure, receptor biology, and pharmacology has enabled the design and engineering of liver-de-targeted capsids ushering in several new vector candidates. This next generation of AAVs offers significant promise for extrahepatic gene delivery to cardiovascular, musculoskeletal, and neurological tissues with improved safety profiles.
Change in disease activity needed for meaningful change in cutaneous lupus by patient characteristic: A retrospective analysis of a longitudinal database
Authors: Julianne Kleitsch, Rachita Pandya, Srita Chakka, Daisy Yan, Darosa Lim, DeAnna Diaz, Rui Feng, Victoria P. Werth
Journal: Journal of the American Academy of Dermatology (2023)
MGMT promoter methylation status prediction using MRI scans? An extensive experimental evaluation of deep learning models
Authors: Numan Saeed, Muhammad Ridzuan, Hussain Alasmawi, Ikboljon Sobirov, Mohammad Yaqub
Journal: Medical Image Analysis (2023)

The number of studies on deep learning for medical diagnosis is expanding, and these systems are often claimed to outperform clinicians. However, only a few systems have shown medical efficacy. From this perspective, we examine a wide range of deep learning algorithms for the assessment of glioblastoma - a common brain tumor in older adults that is lethal. Surgery, chemotherapy, and radiation are the standard treatments for glioblastoma patients. The methylation status of the MGMT promoter, a specific genetic sequence found in the tumor, affects chemotherapy's effectiveness. MGMT promoter methylation improves chemotherapy response and survival in several cancers. MGMT promoter methylation is determined by a tumor tissue biopsy, which is then genetically tested. This lengthy and invasive procedure increases the risk of infection and other complications. Thus, researchers have used deep learning models to examine the tumor from brain MRI scans to determine the MGMT promoter's methylation state. We employ deep learning models and one of the largest public MRI datasets of 585 participants to predict the methylation status of the MGMT promoter in glioblastoma tumors using MRI scans. We test these models using Grad-CAM, occlusion sensitivity, feature visualizations, and training loss landscapes. Our results show no correlation between these two, indicating that external cohort data should be used to verify these models' performance to assure the accuracy and reliability of deep learning systems in cancer diagnosis.
Endoscopic diagnosis of esophageal fistula hidden below massive bleeding assisted by modified external cannula device
Authors: Feifan Chen, Zhihan Wu, Kai Deng, Junchao Wu, Jinlin Yang
Journal: Endoscopy (2023)

A 60-year-old man, with a history of surgery followed by chemoradiotherapy for cardiac cancer 5 years ago, was referred for backache and hematemesis. The abdominal computed tomography angiography (CTA) revealed a pseudoaneurysm of the descending thoracic aorta ([Fig. 1]). Emergency endovascular repair was performed during which contrast media extravasated outside the descending aorta and flowed into the esophagus ([Fig. 2]) before stent graft insertion. The endovascular intervention was successful, but bloody fluid was still drained from the stomach tube, together with hematochezia. A bedside gastroscopy was therefore arranged to detect ongoing or recurrent gastrointestinal bleeding.
Iatrogenic colorectal perforation caused by a clip
Authors: Hirotaka Oura, Yasuki Hatayama, Erika Nomura, Harutoshi Sugiyama, Daisuke Murakami, Makoto Arai, Takayoshi Nishino
Journal: Endoscopy (2023)

An iatrogenic colonic perforation (ICP) is a significant incident associated with colonoscopy, with recent guidelines detailing a treatment-related incidence of 0.02 %–8 % [1]. Although clips are frequently used to suture perforations [2], ICPs caused by the clips themselves have not previously been reported. Here, we describe a case of an ICP occurring during endoscopic treatment that was caused by a clip in a colonic diverticulum.
A case of IgG4-related cholecystitis diagnosed by transpapillary gallbladder biopsy using a novel device delivery system
Authors: Yujiro Kawakami, Naohiro Kameyama, Yosuke Hirobe, Yoshiharu Masaki, Ayako Murota, Shintaro Sugita, Hiroshi Nakase
Journal: Endoscopy (2023)

A 60-year-old man who was previously diagnosed with acute cholecystitis with gallbladder stones was referred to our department for further investigation of gallbladder wall thickening. Blood tests revealed normal serum carcinoembryonic antigen (1.85 ng/mL) and carbohydrate antigen 19–9 levels (8.1 U/mL) and elevated serum immunoglobulin G4 (IgG4) levels (995 mg/dL). Abdominal ultrasonography revealed gallbladder stones and localized wall thickening of the gallbladder fundus ([Fig. 1]). Contrast-enhanced computed tomography revealed wall thickening of both the bile duct and the gallbladder fundus ([Fig. 2]). Endoscopic retrograde cholangiography revealed a contrast agent defect at the gallbladder fundus ([Fig. 3]). To confirm the histological diagnosis, transpapillary gallbladder biopsy was attempted ([Video 1]). A guidewire was inserted to help advance a newly designed endoscopic sheath (Endosheather; Piolax Medical Device, Kanagawa, Japan) into the gallbladder. Through the sheath, a targeted biopsy of the gallbladder fundus lesion was performed using biopsy forceps ([Fig. 4]). Histopathology revealed > 10 IgG4-positive lymphoplasmacytic cells/high-power field, with an IgG4/IgG-positive cell ratio of > 40 % ([Fig. 5]). Based on the pathological findings, we diagnosed the patient with IgG4-related cholecystitis, and we performed a laparoscopic cholecystectomy. Histological examination of the surgical specimens confirmed the gallbladder lesion as IgG4-related cholecystitis.
Endoscopic resection of a large ampullary tumor using a hybrid endoscopic submucosal dissection and mucosal resection technique
Authors: Akshay Sudhir Kulkarni, Tushar Karwat, Shreyash Dubewar, Shrikant Mukewar, Saurabh Mukewar
Journal: Endoscopy (2023)

A 52 year old man was referred with an ampullary lesion and a minor gastrointestinal (GI) bleed. Upper GI endoscopy showed an ulcerated ampullary mass ([Fig. 1]). Mucosal biopsy revealed an ampullary adenoma. Endoscopic submucosal dissection (ESD) was planned.
Tracing the new SARS-CoV-2 variant BA.2.86 in the community through wastewater surveillance in Bangkok, Thailand
Authors: Dhammika Leshan Wannigama, Mohan Amarasiri, Phatthranit Phattharapornjaroen, Cameron Hurst, Charin Modchang, Sudarat Chadsuthi, Suparinthon Anupong, Kazuhiko Miyanaga, Longzhu Cui, Stefan Fernandez, Angkana T Huang, Puey Ounjai, Ratana Tacharoenmuang, Naveen Kumar Devanga Ragupathi, Daisuke Sano, Takashi Furukawa, Kazunari Sei, Asada Leelahavanichkul, Talerngsak Kanjanabuch, Paul G Higgins, Asuka Nanbo, Anthony Kicic, Andrew C Singer, Tanittha Chatsuwan, Sam Trowsdale, Aisha Khatib, Kenji Shibuya, Shuichi Abe, Hitoshi Ishikawa, Parichart Hongsing, Wanwara Thuptiang, Ali Hosseini Rad S M, Porames Vatanaprasan, Dylan John Jay, Thammakorn Saethang, Sirirat Luk-in, Robin James Storer, Phitsanuruk Kanthawee
Journal: The Lancet Infectious Diseases (2023)
Color overlay of contrast-enhanced endoscopic ultrasound for pancreaticobiliary disease
Authors: Haruka Toyonaga, Tsuyoshi Hayashi, Masayo Motoya, Toshifumi Kin, Kuniyuki Takahashi, Akio Katanuma
Journal: Endoscopy (2023)

Contrast-enhanced endoscopic ultrasound (CE-EUS) has been considered an important examination for visualization of blood flow and for its contribution to more accurate diagnosis in various conditions of the pancreaticobiliary region [1] [2] [3] [4] [5]. However, the conventional black and white mode may limit visual discernibility. A new EUS processor (EU-ME3; Olympus Co., Tokyo, Japan) has been equipped with a novel color overlay mode, which could potentially augment the perception of contrast agents, enhancing the utility of CE-EUS. We present three cases in which the color overlay mode of CE-EUS improved visualization during observation and tissue acquisition ([Video 1]).
Bivalent mRNA SARS-CoV-2 vaccination in patients with inflammatory bowel disease
Authors: Joshua Quan, Ante Markovinović, Lindsay Hracs, Christopher Ma, Remo Panaccione, Gilaad G Kaplan, Eric I. Benchimol, Sasha Bernatsky, Gurmeet Bindra, Charles N. Bernstein, Léa Caplan, Carmen Charlton, Stephanie Coward, Kenneth Ernest-Suarez, Michelle Herauf, Jessalyn K. Holodinsky, Richard J.M. Ingram, Jamil N. Kanji, M. Ellen Kuenzig, Cathy Lu, Douglas J. Mahoney, Kerri Novak, Catherine Rowan, Cynthia H. Seow, Nastaran Sharifi, Graham Tipples, LeeAnn Turnbull, Joseph W. Windsor, Fiona Yeaman
Journal: The Lancet. Gastroenterology & hepatology (2023)
Endoscopic ultrasound-guided caudate lobe liver abscess drainage
Authors: Junichi Kaneko, Hiroki Tamakoshi, Moeka Watahiki, Daisuke Kusama, Tomoyuki Niwa, Masaki Takinami, Takanori Yamada
Journal: Endoscopy (2023)

Endoscopic ultrasound (EUS)-guided liver abscess drainage is an alternative method in cases where percutaneous drainage (PCD) is difficult to perform [1] [2]. However, reports on EUS-guided caudate lobe liver abscess drainage remain scarce, with only 12 reported cases [3]. Of these cases, 33 % (4 /12) were treated with a transesophageal approach, which can cause mediastinitis, mediastinal emphysema, and pneumothorax [4] [5]. Herein, we present a case of safe and successful drainage via this method using marking clips and adjusting the scope position.
Endoscopic retrograde appendicitis therapy for giant periappendiceal abscess with intestinal obstruction
Authors: Qianlong Li, Tianyu Liu, Aiying Li, Jing Liu, Biao Jiang, Bo Yang
Journal: Endoscopy (2023)

In recent years, endoscopic retrograde appendicitis therapy (ERAT) has been widely used in the treatment of acute uncomplex appendicitis [1]. However, the treatment of a periappendiceal abscess has always been a challenge. Early surgery may cause serious complications such as total peritonitis and postoperative anastomotic leakage [2]. We report a case of acute appendicitis with a giant periappendiceal abscess and intestinal obstruction. Through ERAT, full endoscopic drainage was achieved and the intestinal obstruction was quickly resolved.
Letter to the editor about ‘Auxiliary use of ChatGPT in surgical diagnosis and treatment’
Authors: Hinpetch Daungsupawong, Viroj Wiwanitkit
Journal: International Journal of Surgery (2023)

aPrivate Academic Consultant, Phonhong, Lao bAdjunct professor, Chandigarh University, India; Adjunct professor, Joesph Ayobabalola University, Ikeji-Arakeji, Nigeria Letter to the editor ""Auxiliary use of ChatGPT in surgical diagnosis and treatment" Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Private Academic Consultant, Phonhong, Lao People's Democratic Republic. E-mail address: [email protected] (H. Daungsupawong). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
The Hospitalist Movement 25 Years Later
Authors: Shradha A. Kulkarni, Robert M. Wachter
Journal: Annual Review of Medicine (2023)

Hospitalists are generalists who specialize in the care of hospitalized patients. In the 25 years since the term hospitalist was coined, the field of hospital medicine has grown exponentially and established a substantial footprint in the medical community. There are now more hospitalists than practicing physicians in any other internal medicine subspecialty. Several key forces catalyzed the growth in the field of hospital medicine, including the quality, safety, and value movements; residency duty hour restrictions; the emergence of electronic health records; and the COVID-19 pandemic. Looking ahead, we see new opportunities in the realms of technology and telemedicine, and challenges persist in regard to balancing financial considerations with increasing workload and burnout. Hospitalists must remain nimble and seize emerging opportunities to continue supporting the field's prominence and growth.
When I use a word . . . Dinitrophenol? Don’t take it
Authors: Jeffrey K Aronson
Journal: BMJ (2023)

Dinitrophenol, or more accurately 2,4-dinitrophenol, is a poisonous chemical that has been used medicinally as a remedy for obesity. However, it is difficult to use, and deaths have been common from its uncontrolled use. It has a very low therapeutic to toxic ratio. Variability in individual dosage requirements is large, making it difficult to find an appropriate dosage regimen in an individual. Long term therapy is exceptionally hazardous, because of accumulation of the chemical and the weight loss that it causes. UK legislation to regulate the sale and use of dinitrophenol has included the Food Safety Act 1990, making it illegal to include dinitrophenol in food intended for human consumption, and a 2023 amendment to the Poisons Act 1972, making it illegal to purchase dinitrophenol without a licence from a registered pharmacist. However, more action is needed to reduce the possibility of obtaining it online from countries outside the UK and via the dark web.
Voting for a Voice
Authors: None The Lancet Global Health
Journal: The Lancet Global Health (2023)

October 14 will be a historic day for Australians: for better or worse. On this day, all Australians older than 18 years must vote yes or no on a constitutional amendment “to recognise the First Peoples of Australia by establishing an [advisory body known as the] Aboriginal and Torres Strait Islander Voice”. Unlike those of most other previously colonised nations, Australia's Constitution makes no mention of its First Nations people; giving such people an opportunity to advise on national policies that affect them therefore seems obvious to the outside observer.
Endoscopic transcecal appendectomy for recurrent appendicitis after previous endoscopic mucosal resection
Authors: Zhi-Lan Ma, Hai-Ting Pan, Jia-Qi Xu, Ping-Hong Zhou, Zhen Huang
Journal: Endoscopy (2023)

A 47-year-old man suffered from acute appendicitis 4 years ago, relieved by a 3-day course of oral levofloxacin. A follow-up colonoscopy 1 year later revealed a 1.5-cm submucosal bulge near the appendiceal orifice. The patient underwent endoscopic mucosal resection (EMR) for the lesion at that hospital ([Fig. 1]) and was referred to our hospital for routine follow-up owing to the possibility of recurrence. Colonoscopy again found a submucosal bulge near the appendiceal orifice with purulent exudates ([Fig. 2]).
Reopenable-clip over-the-line method for closure of large perforation during esophageal endoscopic submucosal dissection
Authors: Yuya Asada, Satoki Shichijo, James Weiquan Li, Noriya Uedo
Journal: Endoscopy (2023)

Perforation during esophageal endoscopic submucosal dissection (ESD) can lead to severe complications; localized muscle defects can result in large perforations during ESD that require surgery [1]. While the effectiveness of endoclips or over-the-scope clip systems (OTSC; Ovesco Endoscopy AG, Tübingen, Germany) for the closure of small perforations is well recognized, there is a limit to the size of defect they can close [2]. Moreover, OTS clips may lead to stenosis [3]. Nomura et al. [4] developed a reopenable-clip over-the-line method (ROLM) for complete closure of mucosal defects after ESD. ROLM requires reopenable endoclips with an opening in the jaw (SureClip, 16 mm; ROCC-F-26–195-C; Microtech, Nanjing, China) and a nylon line (0.22 mm), which is also useful in muscular defect closure [5]. Herein, we report a case in which a large perforation that occurred during esophageal ESD was successfully closed using ROLM.
Early complete response as a validated surrogate marker in extranodal marginal zone lymphoma systemic therapy
Authors: Côme Bommier, Emanuele Zucca, Sylvie Chevret, Annarita Conconi, Grzegorz Nowakowski, Matthew J. Maurer, James R. Cerhan, Catherine Thieblemont, Jérôme Lambert
Journal: Blood (2023)
Complement activation drives antibody-mediated transfusion-related acute lung injury via macrophage trafficking and formation of NETs
Authors: Saskia van der Velden, Thijs L. J. van Osch, Amina Seghier, Arthur E. H. Bentlage, Juk Yee Mok, Dionne M. Geerdes, Wim J. E. van Esch, Richard B. Pouw, Mieke C. Brouwer, Ilse Jongerius, Masja de Haas, Leendert Porcelijn, C. Ellen van der Schoot, Gestur Vidarsson, Rick Kapur
Journal: Blood (2023)